Source: ARKANSAS AGRIC EXTENSION SERVICE submitted to
EXTENSION HEALTH AMBASSADORS: A COMMUNITY-BASED VOLUNTEER HEALTH EDUCATION TRAINING PROGRAM FOR IMPROVING HEALTH IN RURAL ARKANSAS COMMUNITIES
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
Reporting Frequency
Annual
Accession No.
1029146
Grant No.
2022-46100-38174
Cumulative Award Amt.
$349,481.00
Proposal No.
2022-04837
Multistate No.
(N/A)
Project Start Date
Sep 1, 2022
Project End Date
Aug 31, 2025
Grant Year
2022
Program Code
[LX]- Rural Health & Safety Education
Recipient Organization
ARKANSAS AGRIC EXTENSION SERVICE
(N/A)
LITTLE ROCK,AR 72203
Performing Department
(N/A)
Non Technical Summary
To address challenges related to the chronic disease burden in Arkansas, and the health disparities between urban and rural populations, this proposal employs an asset-based community development model, in combination with a lay-leader health training program, that equips community volunteers with the health education and promotion knowledge and skills necessary to lead Extension-based health programs in targeted rural counties.Through this model, the proposed project aims to empower and give agency to volunteers who live in and belong to the communities they serve by identifying human-capital assets that drive the community development process and work to respond to and create local opportunity for addressing community health concerns. Rural, adult residents of the target counties, including under-resourced and underserved populations, serve as the primary audience for this proposal.One of the primary objectives will be to employ the asset-based community development (ABCD) framework to identify community members who could serve as Extension Health Ambassadors (EHAs). This identification process leads into the training of EHAs to deliver health programs with the supervision of County Extension Agents. Ultimately, these EHAs increase access to and availability of Extension health-related programming for rural populations in the target counties.The proposed project team has a successful history of providing culturally-appropriate community health outreach, education, program implementation, evaluation, and training for rural and hard-to-reach populations throughout Arkansas.This approach bridges the gap between diverse populations and improved health, and builds capacity and human capital toward health promotion and the identification of strategies for reducing chronic disease.
Animal Health Component
(N/A)
Research Effort Categories
Basic
(N/A)
Applied
(N/A)
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
72460991020100%
Knowledge Area
724 - Healthy Lifestyle;

Subject Of Investigation
6099 - People and communities, general/other;

Field Of Science
1020 - Physiology;
Goals / Objectives
The primary purpose of this project is to amplify and broaden the reach of Extension health programming in rural communities by training target community volunteers through a community health worker model to deliver health-related programs, alongside County Extension Agents, to larger Extension audiences than could be accoomplished by just the extension agent alone.Objectives:1) Employ ABCD community engagement model for recruiting Extension Health Ambassadors from target communities2) Develop and implement health education training materials and modules to equip County Extension Agents and community volunteers to deliver community-based, health-related Extension programs3) Increase access to and availability of Extension health-related programs delivered by Extension Health Ambassadors in target counties
Project Methods
The project will utilize a community health worker model to train community volunteers to become EHAs. These trained Ambassadors will then deliver health-related programs, alongside County Extension Agents (CEAs), to larger Extension audiences than could be accomplished by just the CEA alone. Through this model, the project aims to empower and give agency to volunteers who live in and belong to the communities they serve.Community volunteers will be expected to complete the Extension Health Ambassador Training Program (Appendix A), consisting largely of online, self-paced knowledge- and skill-enrichment courses, covering topics that include nutrition and physical activity across the lifespan; mental and emotional health; health literacy and numeracy; rural health; chronic disease in Arkansas and the U.S.; cultural competency; social determinants of health; and, health behavior theory, as examples. CEAs will also complete this training and serve as county-level leadership for their volunteers. Each CEA will be tasked, using the ABCD strategy, with identifying up to five community volunteers who will undertake training to become EHAs.Through the EHA program, ABCD will be used to recruit volunteers and sustain a place-based, community-focused process that results in a culture of inclusivity built on a relationship-driven approach, realizing that each community responds in different ways and has different resources. In recruiting volunteers, we will build systematic approach to identifying the challenges and adopting solutions.Once trained, EHAs will be tasked with delivering Extension health-related programming alongside CEAs, who will oversee program delivery and fidelity. As part of this program delivery process, and in concert with the Project Evaluation Lead, EHAs will evaluate community participant knowledge and behavior change.Evaluation activities for the proposed project will follow the processes outlined in the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) and CIRO (Context, Input, Reaction, Output) models. RE-AIM will be used to determine the impact and effectiveness of EHA in the context of 1) volunteer recruitment and training completion, 2) whether project activities are taking place at expected rates, 3) whether targeted audiences are being reached, and 4) whether trained volunteers are actively involved and being retained. In addition, data reported by participating CEAs through the Arkansas Information Management System (AIMS) database will be used for output and outcome data within the scope of RE-AIM. AIMS is the online accountability database for the University of Arkansas System Division of Agriculture Cooperative Extension Service. The CIRO model is a process evaluation model that will be used to determine the volunteer training's effectiveness through 1) training needs and 3-level objectives (immediate, intermediate, ultimate), 2) training delivery format and maintenance, 3) participant feedback on the training's content, approach, and value, and 4) the results of the training as determined by long-term engagement of volunteers. The RE-AIM and CIRO models have been integrated into the EHA logic model and data management plan. Return on investment will be determined by the value of volunteer hours along with the expanded reach the volunteers have added to county programming. This will be determined through the number of sessions taught and the number of people reached. The evaluation will ensure program activities are implemented as intended and meet performance metrics. In addition, the evaluation will help inform adaptations and improvements to the implementation of the program and will measure program effectiveness.

Progress 09/01/23 to 08/31/24

Outputs
Target Audience:In Year 2, our target audience remained rural adults in Hempstead, Clark, Hot Spring, Phillips, Pope, and Mississippi Counties in Arkansas. These primarily rural adults are representative of the state's rural demographic makeup and continue to face disproportionate challenges to improving health outcomes through traditional health promotion and disease prevention measures. From these counties, our Years 1 and 2 recruitment and training of our Extension Health Ambassadors has resulted in the participation of 22new volunteers, who have signed on to be trained as Extension Health Ambassadors for their respective counties. In total, we expected 30 volunteers to be trained as Extension Health Ambassadors however, 22were recruited overall. The 22volunteers were recruited by the County Extension Agents in their respective counties through word-of-mouth strategies that identified local residents interested in improving opportunities for access to healthcare, health education, and health promotion. The 22ambassadors were fully trained in ABCD strategies and health best practices. At the close of year 2 and in the final no-cost extension year, the Extension Health Ambassadors are implementing programs and integrating tools learned into their community engagement. Changes/Problems:Year 2 brought out some common issues with volunteer projects: mismatch between volunteer enthusiasm and project structure, lack of immediate action, emphasis on planning over execution, and uneven training schedules. These common issues made it a challenge to maintain volunteer engagement. Our volunteers were eager to make a difference, and despite their enthusiasm, the project's emphasis on planning over action and the delayed start of practical tasks led to volunteers feeling frustrated. To address this, we need to incorporate early action opportunities and ensure training aligns with immediate application. Even before full training is complete, we need to identify simple tasks that volunteers can contribute to that will reinforce their value to the project. What opportunities for training and professional development has the project provided?The team has provided in-person training in addition to the virtual health best practices training completed by all volunteers and agents in the Extension Health Ambassadors' program. From January to present the team has provided coaching and support to county teams as they implement health programming through an ABCD approach. Asset-Based Community Development Training and Coaching: 3/28/2024: Mississippi County Ambassador Training (two trainings combined into one extended timeframe) 3/18/2024: Phillips County Ambassador Training (two trainings combined into one extended timeframe) 4/6/2023: Hempstead County Ambassador Training 5/8/2023: Pope County Ambassador Training 7/13/2023 Pope County Ambassador Training 8/14/2023: Hempstead County Ambassador Training 8/23/2023: Hot Spring County Ambassador Training 8/23/2023: Clark County Ambassador Training 8/28/2023: Cultivating Joy: ABCD Practical Application Workshop (Mike Mather & De'Amon Harges) 8/29/2023: Hot Spring County Ambassador Training 8/29/2023: Clark County Ambassador Training 9/18/2023: Hempstead County Ambassador Training 9/26/2023: Clark County Ambassador Training 10/11/2023: Pope County Ambassador Training 10/30/2023: Jeder Institute The Essence of Asset-Based Community Development / 2-4 p.m. / DeGray Lake State Park 10/31/2023: Jeder Institute Asset-Based Community Development Connected Leaders / 9a-2p / UA Little Rock Downtown 11/2/2023: Jeder Institute Asset-Based Community Development for Inclusive Leadership / 9a-4p / The Vines Center 11/3/2023: Jeder Institute Asset-Based Community Development for Inclusive Leadership / 9a-12p / Zoom 10/24/2023: Phillips County Ambassador Training 12/12/2023: Phillips County Ambassador Training How have the results been disseminated to communities of interest? Our project teams holds a monthly meeting to ensure all project partners are aware and up-to-date with the timeline, expectations, and accomplishments of the project to date. Recruitment efforts within the community are taking place through word-of-mouth and through County Extension Agent colleague networks to reach deep into the community. Ambassadors are hosting events and reaching out to assets and networks in their county to implement programming. As an example, in Mississippi County, Ambassadors created an online resource tool of health resources. Ambassadors have then worked closely with nonprofit and community-based networks so that the online tool is utilized locally. What do you plan to do during the next reporting period to accomplish the goals?In the final year, through a no-cost extension, we will focus on community volunteer and program implementation as well as long-term ABCD practices to maintain volunteer engagement. We will focus on sustainability efforts with volunteers and agents so that the lessons learned, skill training provided, and projects implemented will live on after the grant. As Ambassadors implement lessons learned through Objective 3 above: Increase access to and availability of Extension health-related programs delivered by Extension Health Ambassadors in target counties, we will perform the following: Activity 1: Identification of program delivery locations, dates, and times Activity 2: Delivery of Extension health programs by Extension Health Ambassadors Activity 3: Evaluate participant knowledge after exposure to Extension Health Ambassador-led health programs Activity 4: Communicate project data and outputs with local, state, and federal stakeholders

Impacts
What was accomplished under these goals? For this reporting period, Objectives 1, 2 and 3 above have been accomplished and are ongoing. Utilizing the ABCD community engagement model, twenty-twovolunteers have been recruited and trained in the Asset-Based Community Development frameworks that they use, in turn, to recruit community participants for Extension health-related programs. Additionally, these twenty-twovolunteers have completed the Extension Health Ambassador online training modules and have received training in: 1.1 Introduction to Public Health & Public Health History 1.2 Analyzing Potential Interventions & Exploring Healthy People 2030 1.3 Advocating for Equity in Public Health & Recognizing Prevention 2.1 Public Health Data 2.2 Identifying Strategies that Influence Behavior Change 2.3 Key Parameters of Effective Public Health Communication & Supporting Public Health Behaviors 3.1 Extension 101 3.2 Volunteer Expectations Volunteers and county agents have completed four ABCD components focused on Asset-Based Community Development Principles Asset Based Community Development in your County: Understanding Assets and Strengths Organizing and implementing through ABCD Motivation and Engagement of Volunteers through ABCD. Additionally, volunteers and Extension agents attended workshops and sessions hosted by national and international experts on ABCD. The Essence of Asset-Based Community Development Asset-Based Community Development Connected Leaders Asset-Based Community Development for Inclusive Leadership.

Publications


    Progress 09/01/22 to 08/31/23

    Outputs
    Target Audience:In Year 1, our target audience remained rural adults in Hempstead, Clark, Hot Spring, Phillips, Pope, and Mississippi Counties in Arkansas. These primarily rural adults are representative of the state's rural demographic makeup and continue to face disproportionate challenges to improving health outcomes through traditional health promotion and disease prevention measures. From these counties, our Year 1 recruitment and training of our Extension Health Ambassadors has resulted in the participation of 24 new volunteers, who have signed on to be trained as Extension Health Ambassadors for their respective counties. Recruitment in Phillips County is ongoing. In total, we expect 30 volunteers to be trained as Extension Health Ambassadors. The 24 volunteers were recruited by the County Extension Agents in their respective counties through word-of-mouth strategies that identified local residents interested in improving opportunities for access to healthcare, health education, and health promotion. Changes/Problems:For this reporting period, the only change made from our original proposal has been the exclusion of Cleburne County and the inclusion of Hot Spring County into the targeted project counties. This is due to the vacancy of the Cleburne County Extension FCS Agent which created a gap in local-level support for the project. The County Extension FCS Agent in Hot Spring County agreed to participate and has worked closely with her community to recruit six Extension Health Ambassador volunteers.? What opportunities for training and professional development has the project provided? Assest-Based Community Development Trainings: 4/6/2023: Hempstead County Ambassador Training 5/8/2023: Pope County Ambassador Training 8/14/2023: Hempstead County Ambassador Training 8/23/2023: Hot Spring County Ambassador Training 8/23/2023: Clark County Ambassador Training 8/28/2023: Cultivating Joy: ABCD Practical Application Workshop (Mike Mather & De'Amon Harges) 8/29/2023: Hot Spring County Ambassador Training 8/29/2023: Clark County Ambassador Training 9/18/2023: Hempstead County Ambassador Training 9/26: Clark County Ambassador Training 10/11/2023: Pope County Ambassador Training 10/30/2023: Jeder Institute The Essence of Asset-Based Community Development / 2-4 p.m. / DeGray Lake State Park 10/31/2023: Jeder Institute Asset-Based Community Development Connected Leaders / 9a-2p / UA Little Rock Downtown 11/2/2023: Jeder Institute Asset-Based Community Development for Inclusive Leadership / 9a-4p / The Vines Center 11/3/2023: Jeder Institute Asset-Based Community Development for Inclusive Leadership / 9a-12p / Zoom Products: Extension Health Ambassador Training This training curriculum aims to provide a detailed overview of a series of essential and project-specific public health issues. In this training, participants learn how to work within their community to support public health through education and awareness. This training is meant to provide participants with the knowledge and skills necessary to implement the components of public health into their work. The program aims to empower participants to support and lead public health initiatives in their community. How have the results been disseminated to communities of interest? Our project teams holds a monthly meeting to ensure all project partners are aware and up-to-date with the timeline, expectations, and accomplishments of the project to date. Recruitment efforts within the community are taking place through word-of-mouth and through County Extension Agent colleague networks to reach deep into the community. Monthly county meetings with Extension Health Ambassadors have been occurring since June 2023, and will continue as we move into program delivery phases and out of the training phases. What do you plan to do during the next reporting period to accomplish the goals? Finalize ABCD and Extension Health Ambassador online training, bringing onboard 30 volunteer Health Ambassadors. Next, will begin the recruitment of community participants for our Extension Health programming. In anticipation of Objective 3 above: Increase access to and availability of Extension health-related programs delivered by Extension Health Ambassadors in target counties, we will perform the following: Activity 1: Identification of program delivery locations, dates, and times Activity 2: Delivery of Extension health programs by Extension Health Ambassadors Activity 3: Evaluate participant knowledge after exposure to Extension Health Ambassador-led health programs Activity 4: Communicate project data and outputs with local, state, and federal stakeholders

    Impacts
    What was accomplished under these goals? For this reporting period, Objectives 1 and 2 above have been accomplished and are ongoing. Utilizing the ABCD community engagement model, twenty-four volunteers have been recruited and trained in the Asset-Based Community Development frameworks that they will use, in turn, to recruit community participants for Extension health-related programs. Additionally, these twenty-four volunteers have begun and/or have completed the Extension Health Ambassador online training modules and have received training in: 1.1 Introduction to Public Health & Public Health History 1.2 Analyzing Potential Interventions & Exploring Healthy People 2030 1.3 Advocating for Equity in Public Health & Recognizing Prevention 2.1 Public Health Data 2.2 Identifying Strategies that Influence Behavior Change 2.3 Key Parameters of Effective Public Health Communication & Supporting Public Health Behaviors 3.1 Extension 101 3.2 Volunteer Expectations?

    Publications